Status and Suspensions

Every waiting list entry has a status that reflects where the patient is in their waiting journey. This page explains each status, how to transition between them, and what information is required at each step.

The statuses

Diarybook uses seven statuses for waiting list entries:

The first four statuses make up the active list. Attended and Removed close an entry. Suspended holds it open but stops the clock.

What the statuses count

The status set separates patients who are genuinely still waiting from patients who have been given a date. That distinction is what makes the numbers on a list mean something specific:

The demand figure is the one most services are asked for, and it is unambiguous here because neither Awaiting Triage nor Waiting can hold a TCI date. Every patient in those two statuses is waiting for something that has not been arranged yet.

Waiting and Scheduled is deliberately not part of that figure. Those patients are still waiting — they have not been seen — but the service has already committed a slot to them. Counting them as unmet demand would overstate the work outstanding; counting them as complete would understate it. Keeping them in their own group avoids both errors.

The waiting time clock and triage

The join date is the date the referral was received, and the clock runs from that point regardless of how long triage takes. A patient who sits in Awaiting Triage for two weeks correctly shows two weeks waiting on the day they move to Waiting. Time spent awaiting triage is not deducted.

This is the correct behaviour rather than a limitation. Both the National Treatment Purchase Fund approach in Ireland and the NHS England Referral to Treatment rules start the waiting time clock at receipt of referral, not at the point a clinician reviews it. A service reporting against either standard can take its figures from Diarybook directly.

Suspension is the only mechanism that stops the clock.

There is one exception to counting from the join date. When a patient has been seen and is now waiting for a review, a Last Attended Date can be set on the entry. Weeks Waiting then counts from that date instead, so the figure reflects the wait since the patient was last seen. The breach date is not affected, and the referral clock described above is unchanged. See Breach Dates and Targets for how both calculations work.

How to change status

1. Open the waiting list entry by clicking on the patient’s row in the list view.
2. In the WL Entry section, click Change Status in the toolbar. The form shows the patient’s current status.
3. If the entry is currently suspended, enter the Suspension End Date *.
4. Select the status in New Status *.
5. Complete the fields that appear for that status (see below).
6. Enter the Reason / Evidence * text.
7. Click Save.

Every status change requires Reason / Evidence text, up to 200 characters, recording why the change is being made. It is logged alongside the change and forms part of the audit trail. If anything required is missing, the form lists what needs fixing before it will save. If you choose the status the entry already has, the form warns you that nothing will change.

The statuses in detail

Awaiting Triage

New entries start here. The patient is on the list and their clock is running, but no clinical decision has been made about them yet.

A priority may already have been set from the referring clinician’s assessment, and the breach date is calculated from it in the usual way. Triage is where that assessment is confirmed or changed.

The form shows the note “The patient stays on the waiting list and the waiting time keeps counting. No further details are needed.”

Entries normally move from here to Waiting once a clinician has reviewed the referral. They can also go straight to Removed if triage determines the referral was inappropriate or the patient does not need to be on this list.

Do not use Awaiting Triage as a holding pen for entries nobody has got to yet. A long-standing Awaiting Triage entry is a referral that has not been clinically assessed, and the clock has been running on it the whole time.

Waiting

The referral has been triaged, the priority is confirmed, and the patient is waiting for a date. This is where most patients on a healthy list sit.

Nothing is required to move an entry here beyond the reason text. Entries reach Waiting from Awaiting Triage after triage, and from Suspended when a suspension ends.

Waiting and Scheduled

A TCI date has been set. The patient remains on the list and continues to count as waiting, because they have not been seen yet.

The form shows a TCI / Appointment Date field. If a TCI date was already set on the entry, it is shown and can be changed.

A note is displayed on the form: “Please note that this option will not remove the patient from the waiting list.”

This is an important distinction, and it is the reason the status is named the way it is. The patient is waiting and scheduled — both are true at once. If your service treats the arrangement of a date as the end of the waiting list journey, use Remove with the reason “Appointment Scheduled” instead. See Choosing between keeping an entry open and removing it below.

If a scheduled date falls through, move the entry back to Waiting. The TCI date is cleared and the patient resumes their position based on their breach date.

Scheduled for Review

A review or assessment appointment has been arranged, as distinct from the definitive appointment or procedure the patient is waiting for.

Use this where the next step in the pathway is a clinician looking at the patient again rather than treating them — for example, where a patient needs reassessment before a decision can be made about whether the original referral still stands, or before their priority can be confirmed.

The form uses the same TCI / Appointment Date field as Waiting and Scheduled, with the note “Record the date of the review appointment. The patient stays on the waiting list and the waiting time keeps counting.”

The entry stays on the active list and continues to be counted, because the patient has not reached the endpoint they were referred for.

Once the review has taken place and the patient is waiting again, consider using Edit to set the entry’s Last Attended Date and Review Due Date. See Review patients.

Attended

The patient attended their appointment or admission.

A note is displayed on the form: “Please note that this option will not remove the patient from the waiting list. An alternative is to choose ‘Removed’ and select the reason as ‘Appointment Attended’”

As with Waiting and Scheduled, the Attended status keeps the entry on the list for tracking purposes. If your workflow treats attendance as the point of completion, use Remove with the reason “Appointment Attended” instead.

An entry can reach Attended directly from any of the waiting statuses. A patient seen at short notice or through a cancellation slot may never have had a TCI date recorded.

Suspended

The patient is temporarily unable or unwilling to proceed, but still requires their place on the list. The waiting time clock stops.

A suspension reason and a suspension start date are required. See Suspensions below for the full detail.

Removed

The patient has been taken off the list. A removal reason is required. See Removal below.

Suspensions

Suspensions pause the waiting time clock. They are used when a patient is temporarily unable to attend but still requires their place on the list. Common reasons include the patient being medically unfit, requesting a deferral for personal reasons, being pregnant, receiving treatment elsewhere, or awaiting investigation results.

Suspending an entry

When changing the status to Suspended, the form shows the note “Please provide the start date and reason for the current suspension”, and two additional fields are required:

Reason for Suspension * — select from the available reasons:

Note that the suspension reason Awaiting Investigations is unrelated to the Awaiting Triage status. The first pauses the clock because the service is waiting on results before it can proceed. The second is an active waiting status with the clock running, used before a clinician has reviewed the referral.

Suspension Start Date * — the date from which the clock should pause. It can be backdated where the reason for suspension began earlier — for example, if the patient called on Monday to say they became unfit the previous week.

Resuming a suspended entry

When changing from Suspended to any other status, the form asks you to “specify the date that the current suspension period ended”, and a Suspension End Date * is required. This is the date the suspension period concludes. The number of days between the suspension start and end dates is added to the cumulative suspended days total on the entry.

Most resumptions go back to Waiting. Where a TCI date has been arranged while the patient was suspended and they are now ready to proceed, going straight to Waiting and Scheduled ends the suspension and sets the date in one step.

For automatically calculated entries, the breach date displayed on the list view is moved forward by the number of days suspended, because the clock was paused during that period. Entries whose dates are managed manually are not moved. See Breach Dates and Targets for details on how this calculation works.

Suspension history

All suspensions are recorded in the Suspensions table on the WL Entry section, which appears once an entry has been suspended. The columns are Start Date, End Date, Reason, Detail, Suspended By and Record Added. If a patient has been suspended more than once, the full history is listed — and the cumulative suspended days reflect the total across all suspension periods.

Removal

Removing a patient from the list is a permanent action within the context of that waiting list entry. The entry remains visible for audit and reporting purposes but is no longer part of the active list.

When changing the status to Removed, the form shows the note “Please note that this option will remove the patient from the waiting list. Please provide the reason for the removal”, and a Reason for Removal * is required:

The removal reason is logged alongside the date and the user who made the change. Where patients are removed following a validation cycle, the validation response provides the supporting evidence. See Client Validation.

The audit log

Every status change — along with the user who made it, the date, the previous status, the new status and the reason text — is recorded in the Log section of the waiting list entry. This log is append-only and cannot be edited or deleted.

The log provides a complete history of the patient’s journey through the waiting list: when they were added, when they were triaged, any priority or detail changes, every suspension and resumption, and how and why they were ultimately removed or marked as attended. This is important both for internal governance and for responding to any queries about a patient’s waiting time.

Choosing between keeping an entry open and removing it

Diarybook deliberately offers two paths for patients who have been given a date or who have attended:

• Waiting and Scheduled, or Attended — the entry stays on the active list. Use this if your team tracks patients through to attendance and wants to see them on the list until the process is fully complete.
• Removed with reason Appointment Scheduled or Appointment Attended — the entry is closed. Use this if your workflow considers the waiting list journey finished once a date is given or the patient is seen.

Neither approach is more correct than the other — it depends on how your service operates. What matters is consistency within a list, because the choice changes what the counts described in What the statuses count represent. A list where some coordinators leave scheduled patients open and others remove them will not produce a reliable figure for either population.

Related

• Adding and Managing Clients — the list view, editing entries and review dates.

• Client Validation — how outbound validation works, what patients see, and how responses feed back into the list.

• Breach Dates and Targets — how breach dates are calculated and how suspensions affect them.